Lumineyes Anterior-Segment Safety Staging (L-SAFE): A Proposed Framework for Pre-Exposure Assessment in Laser Iris Pigment Reduction

Purpose. Repeated laser exposure for iris pigmentation reduction raises a distinct safety question: whether the ocular response to a preceding exposure provides a reason to withhold the next staged exposure. This report proposes the Lumineyes Anterior-Segment Safety Staging (L-SAFE) framework to structure that assessment and its documentation. Framework. L-SAFE is an author-proposed conceptual framework informed by selected literature and general clinical experience, without patient-level data analysis. Four mandatory domains are assessed at each checkpoint: intraocular pressure, anterior-chamber response, corneal status, and angle/outflow status. Findings are integrated into S0 (READY), S1 (WATCH), S2 (PAUSE), or S3 (STOP). Resolving, stable, and progressive trajectory modifiers apply only to S1 and S2. Exposure control. Only S0 indicates absence of an L-SAFE safety contraindication to consideration of the next staged exposure. S1 and S2 require withholding exposure and reassessment; S3 terminates the current staged exposure sequence. Recovery is documented by integrated return to S0. A preceding S2 response remains relevant to subsequent exposure planning. Return to S0 after S3 documents ocular recovery but does not establish eligibility for renewed treatment. Conclusion. L-SAFE proposes a shared vocabulary and a structure for future evaluation. It is not a validated clinical decision rule or evidence that the procedure is safe. Reproducibility, state boundaries, feasibility, and clinical utility require independent evaluation. Preprint — not peer reviewed.